The impact of sleep and mood disorders on quality of life in Parkinson’s disease patients

May 27, 2011Journal of neurology

How sleep and mood problems affect quality of life in Parkinson’s disease

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Abstract

Ninety-three Parkinson's disease patients were analyzed, revealing that poor nocturnal sleep quality is associated with 82% of the variance in quality of life.

Sleep disturbances, measured by the Pittsburgh Sleep Quality Index, correlated significantly with worse quality of life.
Higher levels of anxiety and greater disease severity, assessed using standardized scales, were also linked to reduced quality of life.
In separate analyses, the models indicated that poor sleep quality explained 74% of the variance and excessive daytime sleepiness explained 63% of the variance in quality of life.
In a combined analysis, only poor nocturnal sleep quality remained a significant factor, highlighting its critical role in overall quality of life.

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Sleep disturbances are common and often severe in patients with Parkinson's disease (PD) and their symptoms can be present at any time of day. The purpose of our study was to examine how excessive daytime sleepiness or poor nocturnal sleep quality and mood disorders influence the quality of life (QoL) in PD patients. Ninety-three PD patients from eastern Slovakia were recruited (49.5% males, mean age 68.0 ± 9.5 years, mean disease duration 6.1 ± 5.9 years). Sleep disturbances were measured using the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI); QoL with the Parkinson's Disease Quality of Life Questionnaire (PDQ-39); depression and anxiety with the Hospital Anxiety and Depression Scale (HADS) and disease severity with the Unified Parkinson's Disease Rating Scale (UPDRS). χ (2) test, bivariate correlations and multiple linear regressions were performed. PSQI and ESS had significant correlations with worse QoL (p < 0.01, p < 0.05, respectively). HADS-D (p < 0.01), HADS-A (p < 0.01), UPDRS (p < 0.01) and disease duration (p < 0.05) were also significantly related to worse QoL. In the linear regression analysis, however, only PSQI (p < 0.01), anxiety (p < 0.001) and UPDRS (p < 0.001) remained significant. The model with PSQI explained 74% of the variance, and the model with ESS explained 63% of the variance in PDQ-39 when analyses were performed separately. In an overall model, however, only PSQI remained significant, accounting for 82% of the variance in PDQ-39. Nighttime poor sleep and anxiety are important contributors leading to a worse QoL. As these are treatable conditions, they should be recognized by clinicians and managed properly.

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The impact of sleep and mood disorders on quality of life in Parkinson’s disease patients

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